Repetitive practice after stroke
People who have a stroke commonly experience a loss of strength. The average strength of the affected upper and lower limb in people who have had a significant stroke ranges from 30 to 50% of normal. The loss of strength reduces the extent of participation of people after stroke.
Although progressive resistance training can increase strength after stroke, it can be laborious to set up and progress. An alternative is repetitive practice of tasks (such as walking, reaching and manipulation of objects) without added resistance.
Repetitive practice improves the ability of people to undertake activities after stroke, but its effect on strength is unclear.
A recent systematic literature review identified 52 randomised trials of repetitive task practice after stroke, from which they were able to pool the data on 1928 participants in those studies.
This very powerful analysis clearly showed that repetitive task practice improves strength in people after stroke: by about 15% in the upper limb and by about 28% in the lower limb. These improvements in strength were accompanied by similarly substantial improvements in activity.
For example, the improvement in lower limb activity equated to being able to walk about an extra 8 metres per minute, which is an important improvement in the stroke population.
The authors concluded that repetitive practice should be prioritised as an intervention that can improve both strength and activity in people after stroke.
Want to read deeper into this topic? Have a look at the free full text version of this article published in Journal of Physiotherapy!
> From: de Sousa, J Physiother 64 (2018) 210-221. All rights reserved to the Australian Physiotherapy Association. Click here for the online summary.